Aim <p>Urinary catheterization contributes significantly to hospital-acquired infections. Adhering to CDC guidelines is vital to prevent inappropriate use and reduce infection rates. This study evaluated compliance with these guidelines in hospitalized patients at a tertiary hospital in 2024.</p> Methodology <p>A cross-sectional study assessed compliance with CDC guidelines for preventing catheter-associated urinary tract infections (CAUTIs) in hospitalized patients at Al-Zahra Hospital, Isfahan. Data were gathered through patient observation and chart reviews, evaluating demographics, catheter indications, retention duration, and guideline adherence. Department-specific compliance rates were also analyzed. Standardized checklists ensured consistent data recording.</p> Results <p>Of 1262 patients evaluated, 477 (37.8%) underwent urinary catheterization, with a 57.3% adherence rate to CDC guidelines. The most common appropriate indication was acute urinary retention (15.4%), followed by urine output monitoring in critically ill patients (14.5%) and intraoperative monitoring (11.1%). Adherence was highest in cardiology and urology, while gynecology, rheumatology, plastic surgery, and vascular surgery had the lowest rates. The emergency department showed only 27.8% adherence.</p> Conclusion <p>The findings highlight a suboptimal adherence rate to CDC guidelines in urinary catheterization, emphasizing the need for targeted interventions to improve compliance. Strategic interventions can enhance adherence and subsequently reduce catheter-associated urinary tract infections.</p> Clinical trial number <p>Not applicable.</p>